Course Registration

Course Registration

Thank you for taking the time to answer these questions. Registration is not complete until course fee is received.

Name *

Email *

Phone Number *

What motivates you to take this course? What do you hope to learn? *

Do you have an existing meditation practice? If so, please describe. *

Disclaimer *

Meditation practice can be physically and psychologically challenging. If you are in the midst of deep emotional difficulties such as post-traumatic stress, major depression or untreated addiction, please be sure this course is appropriate for you.
All information provided herein is confidential. The undersigned agrees and does hereby release from liability and hold harmless Heidi Bourne and Pacific Mindfulness. This release is for any and all liability for personal injuries, physical, emotional or mental, (including death) in connection with mindfulness meditation facilitated by Heidi Bourne.